Second toe-to-hand transfer. A surgical option for amputations in the handVergara-Amador, Enrique

Abstract

Background:
The toe to hand transplantation is a method of
reconstruction on the unique or multiple amputations of the fingers.
It can be used the whole toe or with certain modifications as a wrap-
around flap from the big toe or fingertip. It is a widely accepted
option for the thumb.
Methods:
It is a series of patients with amputation of one or
more fingers of the hand were operated with second toe to hand
transplantation. The survival was evaluated and the sensory recovery
by 2-point discrimination.
Results:
We practiced 12 transplants, 8 thumb, and 4 in other
fingers. Ten were adults and 2 children. All transplants survived.
Two patients required tenolysis flexor. The sensibility was recovered
with good 2-point discrimination of 8 mm.
Discussion:
In the more proximal finger amputations, a second
toe is the most appropriate, with lower morbidity of the donor site.
The rates of success are between 95 to 100%. We had a success rate
of 100%. The resulting defect is in the foot is minimum when the
second toe was used. The decision to use one of these techniques
depends on the decision and transplant surgeon training. We always
used the second toe for transfers to the hand, considering that it will
be thinner than the original thumb; our patients had no complaint
about the appearance.
Conclusion:
Toe-to-hand transplantation is a good technique,
providing a very good aesthetic appearance and allowing the
recovery of sensitivity. The defect that is created in the foot does not
produce significant aesthetic and functional alteration